2025 HESI EXIT
V4 EXAM
NCLEX (NGN), Case-based Scenarios,
Actual Qs & Ans to Pass the Exam
THIS HESI EXIT CONSISTS OF
160 Questions and Answers
Multiple-choice Style
Select All That Apply (SATA), ordering, fill-in-the-blank for dosage
including Next Generation NCLEX (NGN) items
Case-based Scenarios
Expert Rationales consistent with HESI−Elsevier/Evolve standards.
,1) A child newly diagnosed with sickle cell anemia (SCA) is being discharged from the
hospital. Which information is most important for the nurse to provide the parents
prior to discharge?
A. Instructions about how much fluid the child should drink daily
B. Signs of addiction to opioid pain medications
C. Information about non-pharmaceutical pain relief measures
D. Referral for social services for the child and family
Correct Answer: A. Instructions about how much fluid the child should drink daily
Expert-Verified Explanation:
• Hydration is crucial for children with sickle cell disease; adequate fluid intake helps
reduce blood viscosity and the risk of vaso-occlusive crises.
• While monitoring for excessive opioid use is important, the more urgent and
universal priority is ensuring daily fluid intake to prevent crises.
• Provide parents with a daily fluid goal based on the child’s weight, age, and activity
level. Show them how to track fluid volumes and encourage the child to sip fluids
frequently.
,───────────────────────────────────────────────────────
─
2) A female client presents in the emergency department and tells the nurse that she
was raped last night. Which question is most important for the nurse to ask?
A. Has she taken a bath since the rape occurred?
B. Is the place where she lives a safe place?
C. Does she know the person who raped her?
D. Did she report the rape to the police department?
Correct Answer: A. Has she taken a bath since the rape occurred?
Expert-Verified Explanation:
• When caring for a sexual assault survivor, preserving evidence is a priority. Asking
whether the client has taken a bath or shower is crucial: bathing could destroy critical
forensic evidence needed if the client decides to press charges.
• Ensuring the client’s immediate safety is also essential, but the top priority question
pertains to preserving medical and forensic integrity.
• Encourage a compassionate, trauma-informed approach: use open-ended, calm,
respectful questioning; ensure privacy and emotional support; involve a Sexual Assault
Nurse Examiner (SANE) team if available.
, ───────────────────────────────────────────────────────
─
3) The nurse is completing the admission assessment of a 3-year-old who is admitted
with bacterial meningitis and hydrocephalus. Which assessment finding is evidence
that the child is experiencing increased intracranial pressure (ICP)?
A. Tachycardia and tachypnea
B. Sluggish and unequal pupillary responses
C. Increased head circumference and bulging fontanels
D. Blood pressure fluctuations and syncope
Correct Answer: B. Sluggish and unequal pupillary responses
Expert-Verified Explanation:
• Changes in pupillary reactions—especially sluggish or asymmetric responses—are a
critical sign of rising intracranial pressure. With bacterial meningitis and potential
hydrocephalus, early detection of ICP changes is key.
• While bulging fontanels and head circumference changes are classic in younger
infants, a 3-year-old’s fontanels are typically closed, so pupillary changes are more
reliable.
• Remind caregivers to watch for subtle neurological changes in children and to report
them immediately. Early intervention can prevent complications such as herniation.
V4 EXAM
NCLEX (NGN), Case-based Scenarios,
Actual Qs & Ans to Pass the Exam
THIS HESI EXIT CONSISTS OF
160 Questions and Answers
Multiple-choice Style
Select All That Apply (SATA), ordering, fill-in-the-blank for dosage
including Next Generation NCLEX (NGN) items
Case-based Scenarios
Expert Rationales consistent with HESI−Elsevier/Evolve standards.
,1) A child newly diagnosed with sickle cell anemia (SCA) is being discharged from the
hospital. Which information is most important for the nurse to provide the parents
prior to discharge?
A. Instructions about how much fluid the child should drink daily
B. Signs of addiction to opioid pain medications
C. Information about non-pharmaceutical pain relief measures
D. Referral for social services for the child and family
Correct Answer: A. Instructions about how much fluid the child should drink daily
Expert-Verified Explanation:
• Hydration is crucial for children with sickle cell disease; adequate fluid intake helps
reduce blood viscosity and the risk of vaso-occlusive crises.
• While monitoring for excessive opioid use is important, the more urgent and
universal priority is ensuring daily fluid intake to prevent crises.
• Provide parents with a daily fluid goal based on the child’s weight, age, and activity
level. Show them how to track fluid volumes and encourage the child to sip fluids
frequently.
,───────────────────────────────────────────────────────
─
2) A female client presents in the emergency department and tells the nurse that she
was raped last night. Which question is most important for the nurse to ask?
A. Has she taken a bath since the rape occurred?
B. Is the place where she lives a safe place?
C. Does she know the person who raped her?
D. Did she report the rape to the police department?
Correct Answer: A. Has she taken a bath since the rape occurred?
Expert-Verified Explanation:
• When caring for a sexual assault survivor, preserving evidence is a priority. Asking
whether the client has taken a bath or shower is crucial: bathing could destroy critical
forensic evidence needed if the client decides to press charges.
• Ensuring the client’s immediate safety is also essential, but the top priority question
pertains to preserving medical and forensic integrity.
• Encourage a compassionate, trauma-informed approach: use open-ended, calm,
respectful questioning; ensure privacy and emotional support; involve a Sexual Assault
Nurse Examiner (SANE) team if available.
, ───────────────────────────────────────────────────────
─
3) The nurse is completing the admission assessment of a 3-year-old who is admitted
with bacterial meningitis and hydrocephalus. Which assessment finding is evidence
that the child is experiencing increased intracranial pressure (ICP)?
A. Tachycardia and tachypnea
B. Sluggish and unequal pupillary responses
C. Increased head circumference and bulging fontanels
D. Blood pressure fluctuations and syncope
Correct Answer: B. Sluggish and unequal pupillary responses
Expert-Verified Explanation:
• Changes in pupillary reactions—especially sluggish or asymmetric responses—are a
critical sign of rising intracranial pressure. With bacterial meningitis and potential
hydrocephalus, early detection of ICP changes is key.
• While bulging fontanels and head circumference changes are classic in younger
infants, a 3-year-old’s fontanels are typically closed, so pupillary changes are more
reliable.
• Remind caregivers to watch for subtle neurological changes in children and to report
them immediately. Early intervention can prevent complications such as herniation.
